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Objective: To understand the epidemiological characteristics of COVID-19 cases in different epidemic stages in Gansu province. Methods: Epidemiological investigation was conducted to collect the information of confirmed COVID-19 cases, including demographic, epidemiological and clinical information. Results: As of 25 February 2020, a total of 91 confirmed COVID-19 cases had been reported in Gansu. The epidemic of COVID-19 in Gansu can be divided as three different stages, i.e. imported case stage, imported-case plus indigenous case stage, and indigenous case stage. A total of 63 cases were clustered cases (69.23%), 3 cases were medical staff infected with non-occupational exposure. The initial symptoms included fever (54.95%, 50/91), cough (52.75%, 48/91), or fatigue (28.57%, 26/91), the proportion of each symptom showed a decreasing trend along with the three epidemic stages, but only the differences in proportions of fever (trend χ2=2.20, P<0.05) and fatigue (trend χ2=3.18, P<0.05) among the three epidemic stages were statistically significant. The cases with critical severe symptoms accounted for 42.85% (6/14), 23.73% (14/59) and 16.67% (3/18), respectively, in three epidemic stages, showed a decreasing trend (H=6.45, P<0.05). Also, the incubation period prolonged along with the epidemic stage (F=51.65, P<0.01), but the intervals between disease onset and hospital visit (F=5.32, P<0.01), disease onset and diagnosis (F=5.25, P<0.01) became shorter along with the epidemic stage. Additionally, the basic reproduction number (R0) had decreased from 2.61 in imported case stage to 0.66 in indigenous case stage. Conclusions: The COVID-19 epidemic in Gansu was caused by the imported cases, and about 2/3 cases were clustered ones. No medical worker was observed to be infected by occupational exposure. With the progression of COVID-19 epidemic in Gansu, the change in initial symptom and incubation period suggests, the early screening cannot only depend on body temperature monitoring.

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Objective: To analyze the epidemiological characteristics of a cluster of 5 confirmed COVIDâ19 cases related with the transmission in incubation period of initial case, and find out the infection source and transmission chain.. Methods: According to "The Prevention and Control Protocol for Coronavirus Disease 2019 (Third Edition)" issued by the National Health Commission, a field epidemiological survey was conducted for the 5 cases in January 2020. Nasopharyngeal swabs and sputum samples were collected from them for the detection of 2019-nCoV by real time RT-PCR. Multi prevention and control measures were taken, such as tracking and screening close contacts, medical isolation observation, investigating the epidemiological link, analyzing transmission chain. Results: Case 1, who had common environmental exposure with other COVIDâ19 cases, got sick on 20 January, 2020 and was confirmed on 1 February. Case 2 became symptomatic on 22 January and was confirmed on 27 January. Case 3 got sick on 25 January and was confirmed on 30 January. Case 4 had illness onset on 20 January and was confirmed on 1 February. Case 5 got sick on 23 January and was confirmed on 31 January. Among the 5 cases, case 2 died and the illness of other cases were effectively controlled. After exclusion of other common exposure factors, case 1 had a 6-hour meeting with case 2 and case 3 on 19 January. Case 2 and case 3 might be infected by case 1 during the incubation period. It is the key point for epidemiological investigation. Conclusion: The epidemiological investigation indicates that the transmission might occur in the incubation period of COVID-19 case, close attention should be paid to it in future COVID-19 prevention and control.

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Objective: To analyze the clinical features and summarize the experience on the diagnosis and treatment of aortic stenosis caused by Takayasu arteritis in pediatric patients. Methods: This study was a retrospective study. Five pediatric patients diagnosed as aortic stenosis caused by Takayasu arteritis in Fuwai Hospital of Chinese Academy of Medical Sciences from January 2016 to August 2018 were included. The clinical features, methods of examination, treatment and outcome were analyzed. Results: There were 2 male and 3 female patients in this cohort. The age of onset ranged from 10 to 13 years. The main clinical symptoms were as follows: intermittent claudication and hypertension (5 patients), heart failure (3 patients). Three patients with heart failure were misdiagnosed with dilated cardiomyopathy in other hospitals. Except 1 patient died due to disease aggravation before operation, the other 4 patients received interventional therapy for severe heart failure or refractory hypertension on the basis of hormone anti-inflammatory treatment, including 2 patients treated with aortic balloon dilatation and 2 patients treated with aortic balloon dilatation and stent implantation. In post-operational follow-up, clinical symptoms and laboratory examination values of the 4 patients treated with interventional therapy were significantly improved. Conclusions: The clinical symptoms of pediatric patients with aortic stenosis caused by Takayasu arteritis mainly present with intermittent claudication, hypertension and heart failure. Aortic intervention strategy should be applied for pediatric patients with severe heart failure or refractory hypertension as early as possible.

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Objective: To analyze the epidemiological and spatial-temporal distribution of Brucellosis, epidemic encephalitis B and hemorrhagic fever with renal syndrome (HFRS) in Gansu province during 2014-2018 so as to provide evidence for the prevention and control of those diseases. Methods: A database was established in Gansu province from 2014 to 2018, using the geographical information system. A spatial distribution map was drawn, with trend analysis and space-time clustering used to study the 3-dimention of the diseases, by using both ArcGIS 10.5 and SaTScan 9.6 softwares. Results: Results from the trend surface analysis showed that the incidence of Brucellosis decreased gradually from north to south parts while the U type curve could reflect the distribution from the east to the west areas. Incidence of epidemic encephalitis B decreased significantly from south to north areas in the province, with incidence higher in the eastern than in the mid-west region. Difference on the incidence of HFRS was not significantly visible in the eastern and western regions, while the incidence was slightly higher in the southern than the northern parts of the province. Spatial and space-time clustering did exist among the 3 diseases in Gansu from 2014 to 2018. The areas with clusters of Brucellosis appeared in the eastern parts during 2014-2015, including 19 counties. The areas with secondary clusters of Brucellosis were seen in the Hexi district, including 4 counties, during 2017-2018. The areas with high incidence of epidemic encephalitis B were clustered in the middle and southeast areas, including 32 counties, during 2017-2018. Areas with most clusters of HFRS appeared in Min county of Dingxi city in 2018, with the areas of secondary clusters in 8 counties of the eastern areas in 2018. Conclusions: The overall incidence rates of the 3 natural focus diseases were in a upward trend and showing obvious characteristics on spatial clustering. According to the distributive characteristics, effective measures should be developed accordingly.

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OBJECTIVE: Recently, long noncoding RNAs (lncRNAs) have attracted more attention for their roles in tumor progression. The aim of this study was to investigate the role of lncRNA ZFPM2 antisense RNA 1 (ZFPM2-AS1) in the progression of renal cell cancer (RCC), and to explore the possible underlying mechanism. PATIENTS AND METHODS: Expression levels of ZFPM2-AS1 in both RCC cells and 50 paired tissue samples were detected by Real Time-quantitative Polymerase Chain Reaction (RT-qPCR). Moreover, the relationship between lncRNA ZFPM2-AS1 expression level and clinic-pathological characteristics as well as patients' disease-free survival rate was explored, respectively. Furthermore, cell proliferation assay, wound healing assay and transwell assay were performed to investigate the role of lncRNA ZFPM2-AS1 in vitro. In addition, Western blot assay, Luciferase reporter gene assay and RNA immunoprecipitation assay were used to explore the possible underlying mechanism. RESULTS: The expression level of ZFPM2-AS1 in tumor tissues was significantly higher than that of corresponding normal tissues. ZFPM2-AS1 expression was associated with lymph node metastasis, tumor stage and survival time of RCC patients. Moreover, the overexpression of ZFPM2-AS1 significantly promoted the growth, invasion and migration of tumor cells, whereas remarkably inhibited cell apoptosis in vitro. Further experiments revealed that miR-137 was a direct target of ZFPM2-AS1. In addition, miR-137 expression in tumor tissues was negatively correlated with ZFPM2-AS1 expression. CONCLUSIONS: Our findings indicated that ZFPM2-AS1 could promote metastasis and proliferation, whereas inhibiting the apoptosis of RCC via targeting miR-137. This study might provide a new vision for interpreting the mechanism of RCC development.

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Mucinous adenocarcinoma is most commonly found in the digestive tract,and the prognosis is poor.We present here a case of primary mucinous adenocarcinoma of the larynx, which is an extremely rare entity and very few have been reported in the literature.A 72-year-old male complained of intermittent hoarseness for over 2 months of duration.Fiberoptic laryngoscope showed negative result for tumor.While CT scan showed laryngeal space occupying lesion,and thyroid cartilage damage was observed.The patient underwent total laryngectomy.Histopathological examination and immunohistochemistry(IHC) analysis supported the diagnosis of mucinous adenocarcinoma.

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Objective:To discuss multiple-factor analysis of serum allergen distribution of patients with allergic rhinitis and level of main allergen IgE in Shenyang area, and to provide a scientific basis for the prevention of allergic rhinitis in this area.Method:Serum IgE was detected in 749 casesï¼»501 cases of male (66.8%), and 248 cases of female (33.2%)ï¼½, with allergic rhinitis.The age range was from 3 to 65 years old, and they were divided into 5 groups based on age. A questionnaire survey was conducted to analyze the distribution of serum allergens and to carry out a multiple-factor analysis of level of the main allergen IgE in patients.Result:The primary allergen was house dust mite/dust mite in each age group, and the differences in the positive rate of elm, mold, cat/dog fur scurf, cockroach and ragweed among different groups were statistically significantï¼P<0.01 or P<0.05ï¼.The ingested allergen sequencing for all age groups: the distribution of 7-14 years old group and 15-35 years old group were consistent with that of the whole, among the under 6 years old group, mango and pineapple was ranked 1st,beef and mutton was ranked 2nd,the occurrence rate of shrimp and crab rose to the 3rd place, among the 36-60 years old group, mango, pineapple and milk was ranked 1st, egg was ranked 2nd, and beef and mutton ranked 3rd, the differences in positive rate of mango and pineapple, beef and mutton, crab and nut among all groups were statistically significant(P<0.01 or P<0.05).The IgE level of cockroach was impacted by the allergic history, home cultivation of flowers and plants and animal domestication. The IgE level of mold was impacted by sex, allergy history, home rearing of pet and furniture updates. The IgE level of wormwood was impacted by allergy history and asthma history. The IgE level of peanut was impacted by age and allergy history. The IgE level of egg was impacted by history of food and drink allergy, home cultivation of flowers and plants and home rearing of pet. The IgE level of crab was impacted by the allergy history and home rearing of pet.Conclusion: The primary inhaled allergen in all groups is house dust mite/dust mite, and the ingested allergen varies in each group, which has provided a reference basis for prevention of ingested allergy.The varying influence factors for IgE level of primary allergens could be used to prevent the patients from contacting the allergen,and each risk factor has become a focus of prevention and control for patients, offering a major help to the prevention and treatment of allergic rhinitis.

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Objective: To optimize the warning threshold values of common communicable diseases in Gansu province, and improve the early warning effect. Method: An early warning model was set up for influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and hand foot and mouth disease (HFMD) respectively in Gansu by using the moving percentile method and cumulative sum method. By calculating the sensitivity, specificity, predictive value of positive test, predictive value of negative test, Youden' index and receiver-operating characteristic curve, the optimum early warning threshold values for communicable diseases in Gansu were selected. Results: The optimum early warning boundary values of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, and viral hepatitis type E were P(90), P(80), P(95), P(90), P(80) and P(90) respectively. The optimum early warning parameters of HFMD were k=1.2, H=5σ. Under the optimum early warning boundary values/parameters, the early warning sensitivities of influenza, scarlet fever, other infectious diarrheal diseases, dysentery, typhoid and paratyphoid, viral hepatitis type E and HFMD were 86.67%, 100.00%, 91.67%, 100.00%, 100.00%, 100.00% and 100.00%, the specificities were 86.49%, 62.22%, 75.00%, 100.00%, 97.92%, 89.13% and 74.47%. The predictive values of positive test were 72.22%, 29.17%, 52.38%, 100.00%, 80.00%, 54.55% and 29.41%, and the predictive values of negative test were 94.12%, 100.00%, 96.77%, 100.00%, 100.00%, 100.00% and 100.00%, and the Youden' indexes were 0.73, 0.62, 0.67, 1.00, 0.98,0.89 and 0.74. Receiver-operating characteristic curve showed that the values/parameters of this warning boundary were the points closest to the upper left of the coordinate diagram. Conclusion: The early warning thresholds of influenza, other infectious diarrheal diseases, dysentery and hepatitis E in Gansu may be raised appropriately and the early warning parameters of HFMD need to be adjusted to improve the effectiveness of early warning.

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Objective: To understand the dominant pathogens of febrile respiratory syndrome (FRS) patients in Gansu province and to establish the Bayes discriminant function in order to identify the patients infected with the dominant pathogens. Methods: FRS patients were collected in various sentinel hospitals of Gansu province from 2009 to 2015 and the dominant pathogens were determined by describing the composition of pathogenic profile. Significant clinical variables were selected by stepwise discriminant analysis to establish the Bayes discriminant function. Results: In the detection of pathogens for FRS, both influenza virus and rhinovirus showed higher positive rates than those caused by other viruses (13.79%, 8.63%), that accounting for 54.38%, 13.73% of total viral positive patients. Most frequently detected bacteria would include Streptococcus pneumoniae, and haemophilus influenza (44.41%, 18.07%) that accounting for 66.21% and 24.55% among the bacterial positive patients. The original-validated rate of discriminant function, established by 11 clinical variables, was 73.1%, with the cross-validated rate as 70.6%. Conclusion: Influenza virus, Rhinovirus, Streptococcus pneumoniae and Haemophilus influenzae were the dominant pathogens of FRS in Gansu province. Results from the Bayes discriminant analysis showed both higher accuracy in the classification of dominant pathogens, and applicative value for FRS.

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Objective: To evaluate the effect of stenting for proximal atherosclerotic extracranial vertebral artery stenosis. Methods: A total of 204 proximal atherosclerotic extracranial vertebral artery stenosis patients underwent stent implantation at Fuwai Hospital were enrolled consecutively between August 2007 and June 2014 prospectively. Medical records were collected and the clinical results were obtained through outpatient and telephone follow up. Results: (1) The patients were (64.1±7.9) years old, and 179 were male (87.7%). (2) Stent implantation was performed on 210 proximal atherosclerotic extracranial vertebral artery stenosis lesions with 210 stents (156 on the left, 54 on the right), and 6 patients received both sides stent implantations. Technical success rate was 100%(210/210). The stenosis of the lesions was decreased from (85.1±6.4) % to (6.5±3.2) % after the stent implantation (P<0.01). (3) Three (1.5%) patients experienced transient ischemic attack during the procedure, and two (1.0%) patients suffered from minor posterior circulation ischemic strokes on the 2nd and 10th day after the procedure, respectively. (4)The median follow-up was 1.5 (0.8-2.5) years. Three(1.5%) patients died (two non-vacular deaths, and the other one due to sudden cardiac death). Three (1.5%) patients developed stroke (one case ipsilateral posterior circulation stroke, and two cases unrelated area stroke). Four (2.0%) patients experienced transient ischemic attack. One patient suffered nonfatal myocardial infraction. In-stent restenosis occurred in thirty nine (19.4%) patients, of which fourteen (35.9%) patients were totally occluded and four (10.3%) patients with symptomatic restenosis. Kaplan-Meier survival curve showed that the primary patency rate of the vertebral artery were 85.6%, 78.6%, 72.2% and 64.4% at 1, 2, 3 and 5 years, respectively. Conclusions: Stenting for proximal atherosclerotic extracranial vertebral artery stenosis is safe and feasible, with a good middle to long-term patency rate. However, further trials are required to validate the effective results found in this patients cohort.

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Objective:To evaluate the postoperative pain degree on OSAHS patients following UPPP, analyze the pain characteristic during seven consecutive days, and discuss the mechanism. To observe the analgesia effect by using flubiprofen axetil. Finally making a comprehensive understanding about UPPP perioperative period and providing more choices about analgesia treatment.Method:Fifty-five patients who underwent UPPP in the First Hospital of China Medical University were divided into analgesia groupï¼înî=30ï¼and control groupï¼înî=25ï¼.Normal saline 50 ml+ flubiprofen axetil 100 mg was used bid for pain relief in analgesia group during seven days following operation, and normal saline 50ml was used in control group.A visual analog scale(VAS) was used for measuring mean pain intensity each day during the period from operative day to the post-operative 7th dayï¼scores were recorded. Continuous changes about pharynx pain were observed and VAS pain scores were compared betweenanalgesia groupand control group. Result:VAS pain scores were the highest on the operative day and the post-operative 1st day, median (interquartile range) was 7ï¼5.5-8.25ï¼ï¼7ï¼6-8ï¼respectively,then decreased gradually. The most significantly decrease happened on the post-operative 2nd and 5th day(P<0.01). Pain scores in analgesia group were most significantly lower than control group from the operative day to the post-operative 4th day(P<0.01), were lower during the post-operative 5th and 6th day(P<0.05),no difference on the post-operative 7th day. Conclusion:The most painful period following UPPP is from the operative day to the post-operative 1st day, then pain decreases gradually. The pain reduces significantly on the post-operative 2nd and 5,6th day.Surgical trauma, in flammatory reaction and suture pulling may be the reason of pain. Flubiprofen axetil effectively reduces pain and the suggested analgesia period is from the operative day to the post-operative 4th-6th day.

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Objective:To learn the relationship between the auditory steady state responses(ASSR)threshold and C-level and behavior T-level in cochlear implants in prelingually deaf children.Method:One hundred and twelve children with Nucleus CI24R(CA) cochlear implants were divided into residual hearing group and no residual hearing group on the basis of the results of ASSR before operation in this study.Compare the difference between the two groups in C-level and behavior T-level one year after operation. Result:There was difference in C-level and behavior T-level between residual hearing group and no residual hearing group(P<0.05 or P<0.01). Conclusion:According to the results of ASSR before operation,we can estimate the effect of cochlear implants,providing reference for the selection of choosing operating ears,and providing a reasonable expectation for physicians and parents of the patients.

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Objective:To discuss the total incidence and characteristics of carotid canal dehiscence in Chinese adults with high resolution CT. At the same time, it provide basic data for otology clinical medical personnel to further understand the anatomical structure of ear and carry out auditory surgery.Method:Temporal bone HRCT images of 643 consecutive subjects who underwent CT scanner were analyzed retrospectively. The coronal, sagittal, and oblique sagittal plane were reconstructioned for some suspected subjects. Contrast the incidence of carotid canal dehiscence in different sex, bilateral and age groups.Result:In 643 patients, 43 cases found the carotid canal dehiscence, and the total incidence of carotid canal dehiscence was 6.7%.The incidence of carotid canal dehiscence for male and female were 5.9%(16/269)and 7.2%(27/374)(P > 0.05),and there was no statistically significant difference in the incidence of carotid canal dehiscence between sexes. The incidence of carotid canal dehiscence for age 40-59 was much higher than those of other age groups (P< 0.05),however, there was no significant difference between groups of age 20-39 and ≥60(P> 0.05).The location of the carotid canal dehiscence in 43 cases was located in the mesotympanum near the Eustachian tube orifice. Carotid artery tube ruptures are mostly small defects, but 11 cases with major defect.Conclusion:The toatal incidence of carotid canal dehiscence is 6.7% in Chinese adults (males: 5.9%,females: 7.2%), especially high incidence at group of age 40-59 (10.7%). Carotid canal dehiscence can be diagnosed accurately by HRCT and multiplanar reconstruction.

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OBJECTIVE: To determine the mechanism of sunitinib-induced autophagy in renal cell carcinoma cells. METHODS: MTS assay was applied to detect the cell viability alteration under the treatment of sunitinib (2, 8 µmol/L). The sunitinib-induced autophagy as well as cell apoptosis was measured and compared after knocking down autophagy-related protein Beclin1 and microtubule associated protein 1 light chain 3 fusion protein (LC3) by RNA interference. The transmission electron microscope was used to observe the formation of autophagosomes in ACHN cells. The fluorescence microscope was used to monitor distribution and aggregation of endogenous LC3-II. The expressions of protein such as LC3-II, the autophagic regulation molecules protein kinase B/ mammalian target of rapamycin (Akt/mTOR) and the symbol of apoptosis poly ADP-ribose polymerase (PARP) were capable to be detected by immunoblotting assay. RESULTS: Sunitinib was able to significantly trigger cell viability loss in the renal carcinoma cell ACHN, which was both in a concentration-dependent and time-dependent manner (P<0.05). After reducing the autophagy by knocking down Beclin1 and LC3, the number of cleavage of PARP was increased remarkably, whereas there was nearly not any cleavage in the mock group. By the transmission electron microscope, there were more autophagic vacuoles in ACHN cells after being administrated with sunitininb compared with the control. And the nuclear-to-cytosol translocation as well as aggregation of LC3-II was presented after sunitinib treatment by the fluorescence microscope, which was the proof of the enhanced autophagy. According to the immunoblotting, sunitinib was able to increase the accumulation of LC3-II . At the same time, the result of sunitinib combined with chloroquine, a drug which blocked the fusion of autophagosomes and lysosomes, demonstrated that the increasing amount of LC3-II was due to the enhanced autophagy flux by sunitinib treatment in ACHN cells. However, phosphorylation of Akt as well as mTOR was decreased at the same time. The rapamycin (mTOR inhibitor) or knocking down Akt subunits could change the sunitinib-induced LC3 -II accumulation, whereas overexpression of Akt subunits decreased the autophagic flux, indicating that Akt/mTOR was the target of sunitinib in autophagy. CONCLUSION: Sunitinib induced autophagy via suppressing Akt/mTOR pathway, and the autophagy was involved in apopotosis.

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OBJECTIVE: To investigate the clinical and pathological features of laryngeal tuberculosis. METHODS: The clinical data of 75 patients with laryngeal tuberculosis from Jan 2010 to Jan 2013 in our hospital were studied retrospectively. There were 50 male and 25 female patients, aged from 18 to 91 years, with a median age of 44 years. The course of disease was 1 to 19 months. RESULTS: The prominent presenting symptoms were hoarseness (n=59, 79%), and sore throat (n=48, 64%). Systemic symptoms included fatigue with weight loss (n=26, 35%) and fever (n=17, 23%). Primary laryngeal tuberculosis was found in 23 patients (31%) while secondary laryngeal tuberculosis together with pulmonary tuberculosis in 52 patients (69%). There were 2 or less lesions in the larynx in 44 patients, while multiple lesions were found in 31 patients. Vocal cords were the most common sites affected(n=51, 68%), followed by epiglottis(n=41, 55%). Proliferation was the main type of lesions (n=34, 45%). After pathologic diagnosis, all patients received systemic anti-tuberculosis therapy, and the prognosis was good. CONCLUSIONS: Severe local symptoms of the larynx with slightly general symptoms are the clinical characteristics of laryngeal tuberculosis for the time being. Primary laryngeal tuberculosis often present with fewer (2 or less) lesions. Different morphology of laryngeal lesions can exist at the same time. The diagnosis of laryngeal tuberculosis depends on pathological biopsy. The treatment should be systemic anti-tuberculosis therapy.

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BACKGROUND: Renal artery fibromuscular dysplasia (RAFMD) is a non-atherosclerotic cause of renal artery stenosis often affecting the young. Percutaneous transluminal renal angioplasty (PTRA) is the treatment of choice but there are few studies of the outcome of the procedure. METHODS: This retrospective analysis included 64 patients (56.2 % female; mean age at diagnosis, 28.0 years) with RAFMD who underwent PTRA between November 2003 and August 2015. Technical and clinical success rates and restenosis rates were evaluated. RESULTS: Seventy-six procedures were performed on 64 RAFMD patients. Technical success was 96.9 %, as defined by <30 % residual stenosis, with stent placement required in 11 patients (17.2 %). In the short term (1 month), the majority (79.7 %) had an immediate clinical benefit, with cure of hypertension in 35.9 %, and improvement in hypertension and a lower requirement for antihypertensive medications in 43.8 %. In the long term (mean, 47.5 months; range, 5-141 months), the survival rate was 96.9 %, freedom from restenosis was 84.4 %, and 76.6 % of patients showed a sustained clinical benefit (cure rate 40.6 %, improvement rate 35.9 %). Eight patients were treated with a second procedure and two had a third procedure, with half of these patients showing an improvement in hypertension. CONCLUSION: PTRA for symptomatic RAFMD is safe and clinically successful. More than half of patients experience an immediate clinical benefit with sustained long-term effects. For patients with restenosis, there was a good response to a second PTRA.

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OBJECTIVE: To investigate the long-term efficacy of continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep apnea syndrome (OSAS). METHODS: This case control study was performed among 154 patients with moderate or severe OSAS between September 2009 and September 2014. Patients were divided into treatment group (n=66, 53 patients with hypertension) and control group (n=88, 67 patients with hypertension). The long-term efficacy of CPAP treatment on clinical events and blood pressure was evaluated. RESULTS: The combined incidence of death, myocardial infarction, coronary revascularization and stroke events was 1.5% (1/66) in treatment group and 11.4% (10/88) in control group (P<0.05). CPAP treatment also led to more significant reduction in systolic blood pressure ((12.24±18.06) mmHg(1 mmHg=0.133 kPa) to (4.24±16.63) mmHg, P<0.05) in the patients with hypertension in these two groups. CONCLUSIONS: CPAP treatment could reduce the risk of cardiovascular and neurovascular events for patients with moderate or severe OSAS.

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Objective:To analyze the relationship of tinnitus and early stage damage of cochlear, to explore the clinical applied value of distortion product otoacoustic emission(DPOAE) and auditory brainstem response(ABR) in the bilateral tinnitus patients with normal hearing capability. Method:There are 30 cases(60 ears) in the tinnitus group with bilateral tinnitus patients with normal hearing capability, and there are 30 cases(60 ears) in the control group without tinnitus of normal hearing capability. The two groups both test the DPOAE and ABR,and compare the results of the DPOAE and ABR. Result:The passing rate of DPOAE in all frequencies was 100% in the control group,42.67% in the tinnitus group. Significant differences existed between the two groups(P<0.05).The DPOAE could be checked out at all frequencies under 2 kHz except 0.75 kHz in the tinnitus group, and the passing rates of DPOAE were significantly lower than those in control group(P<0.05).There were 3 cases could not be checked out at 0.75 kHz frequency, but there were no significant difference(P>0.05).The DPOAE amplitudes at frequencies of 3 to 8 kHz in tinnitus ears were significantly lower than those in nontinnitus ears(the P value were 0.011,0.013,0.008,0.027 ).Wave â ,â ¢ and â ¤could be detected in all ears tested at 80 dB nHL. The latencies of Waveâ in tinnitus group were obviously prolonged.The latencies of Wave â ¢ and â ¤ in tinnitus group were also prolonged, but there was no significant difference(P>0.05).The interval between waves â and â ¢,waves â ¢ and â ¤and wavesâ and â ¤ showed no difference. Conclusion:The maybe cochlear early injury in fractional bilateral tinnitus patients with normal hearing capability, DPOAE and ABR can act as an objective method for diagnosing peripheral tinnitus.

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Objective:To investigate the correlation between the site of prelingual cochlear stimulation and its effect on electrically evoked compound action potentials. Method:Recordings of auditory nerve responses were conducted in 32 prelingual subjects to demonstrate the feasibility of ECAP recordings using the nerve response telemetry(NRT) feature of the Nucleus CI24R(CA) system software. These recordings were then analyzed based on the site of cochlear stimulation defined as basal, middle and apical to determine if the amplitude, threshold and slope of the amplitude growth function and the refractory time differs depending on the region of stimulation. Result:Findings of our prelingual children showed significant differences in the ECAP recordings depending on the stimulation site. Comparing the apical with the basal region, on average higher amplitudes, lower thresholds and steeper slopes of the amplitude growth function hadbeen observed. The refractory time showed an overall dependence on cochlear region; however post-hoc tests showed no significant effect between individual regions. Conclusion:Obtaining ECAP recordings is also possible in the most apical region of the cochlea. However, differences can be observed depending on the region of the cochlea stimulated. Specifically, significant higher ECAP amplitude, lower thresholds and steeper amplitude growth function slopes have been observed in the apical region. These differences between prelingual children and adults could be explained by the location of the stimulating electrode with respect to the neural tissue in the cochlea, a higher density, or an increased neural survival rate of neural tissue in the apex.

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